Unyvero HPN and LRT Panels for Rapid Detection of Bacterial Co-Infections in COVID-19 Pneumonia

Already, some studies have found that 1 in 7 patients hospitalized with COVID-19 has acquired a dangerous secondary bacterial infection (Zhou et al., 2020). These co-infected patients have a higher risk of mortality according to reports that 50% of COVID-19 patient deaths were due to secondary infections (Morris, Cleary, Clarke 2020, Zhou et al., 2020). Approximately 20-30% of hospitalized patients co-infected with the SARS-CoV-2 virus and pneumonia have required intensive care for respiratory support (Huang et al., 2020, Wang et al., 2020). Treatment of severely ill patients with mechanical ventilation is known to increase the risk of bacterial infections, and where antimicrobial resistance is rampant, even higher risks for complications and mortality can be expected.

Among co-infected respiratory pathogens detected in SARS-CoV-2 positive patients, Mycoplasma pneumoniae (23%) and Legionella pneumophila (20%) have been reported (Xing et al., 2020). Acinetobacter baumannii, highly resistant to antibiotics, and Klebsiella pneumoniae also have been reported in cultures obtained from COVID19-positive patients and indicate a higher possibility of these patients to develop septic shock (Chen et al., 2020). Rapid molecular diagnostics that detect a comprehensive spectrum of clinically relevant bacterial pathogens and antibiotic resistance markers are crucial to inform early adjustment of the antibiotic treatment regimen for these secondary bacterial infections to prevent fatal outcomes.

Patients hospitalized with bacterial infections at the time of the 2003 SARS-CoV outbreak were found to be at high risk of being co-infected with SARS-CoV and acting as super-spreaders (defined by one patient infecting more than 10 additional persons). A study reported that 157 out of 206 (76%) SARS-CoV infections were acquired in a healthcare facility and hospitalized patients with bacterial infections were identified as potential sources of super-spreading (Wilder-Smith, Green, & Paton, 2004). To contain the current SARS-CoV-2 pandemic, patients with bacterial infections should be identified, triaged, and isolated using rapid molecular diagnostic technologies to (a) limit adverse outcomes in high risk patients carrying bacterial infections and (b) limit further spreading of SARS-CoV-2 infections in healthcare facilities. This is especially relevant as hospital-related infections have also been widely reported for the current SARS-CoV-2 outbreak (Swift, 2020).

Curetis provides a fast and simple CE IVD marked molecular diagnostic panel for detection of lower respiratory tract infections / pneumonia to help with rapid diagnosis and earlier antibiotic treatment decisions for these critically ill patients.

For treatment and better outcomes for patients with bacterial co-infections such as severe pneumonia a rapid detection of the pathogens and associated resistance markers is essential to guide the right antibiotic treatment. The Unyvero system is a rapid molecular diagnostic platform used for reliable and accurate diagnosis of severe infectious diseases such as Hospitalized Pneumonia (HPN), Blood Stream Infections (BCU), Implant & Tissues Infections (ITI), Intra-Abdominal Infections (IAI) and Urinary Tract Infections (UTI). The system uses powerful multiplex PCR technology to detect a wide variety of microorganisms, antibiotic resistance markers, or toxins from sample-to-answer within 4-5 hours.

The CE IVD marked Hospitalized Pneumonia (HPN) Cartridge can be used to detect the most dangerous and highly resistant microorganisms defined by WHO as:

• Pathogens causing severe forms of pneumonia, e.g. Pseudomonas aeruginosa
• Pathogens carrying antibiotic resistance e.g. Klebsiella pneumoniae and Acinetobacter baumannii complex
• Infections with multidrug-resistant bacteria, which may not be targeted by empirical treatment